Abstract

Introduction

Linezolid-induced black hairy tongue has been rarely reported. The purpose of this
paper is to report a case of linezolid-induced black hairy tongue and review the literature.

Case presentation

A 56-year-old Caucasian man was admitted with community-acquired pneumonia that failed
to respond to levofloxacin 750mg daily. He was started on linezolid and meropenem
and was subsequently discharged home on oral linezolid 600mg every 12 hours and intravenous
ertapenem 1g daily. On a follow-up clinic visit, day 14 of linezolid therapy, he complained
of dysgeusia and his tongue examination was consistent with black hairy tongue. After
he finished his antibiotic course, his complaints resolved with regular tongue brushing.

Conclusion

Black hairy tongue is characterized by abnormal hypertrophy and elongation of filiform
papillae. Five reported cases of linezolid-induced black hairy tongue were identified
in a MEDLINE search (from January 2000 to June 2012). The Naranjo Probability Scale
revealed a probable adverse drug reaction of linezolid-induced black hairy tongue.
Potential contributing factors included other antibiotics, drug–drug interaction and
poor oral hygiene. Health care professionals should be aware of the possibility of
linezolid-induced black hairy tongue. Thorough history for other possible contributing
factors should be obtained. Patients on linezolid should be counseled to perform good
oral hygiene.